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    <title>病患新建</title>
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<body class="hold-transition skin-purple sidebar-mini">

<div class="wrapper">

    <div th:replace="commons/bar::#headerbar"></div>
    <div  th:replace="commons/bar::#sidebar"></div>
    <!-- 导航侧栏 /-->

    <!-- 内容区域 -->
    <div class="content-wrapper">

        <!-- 内容头部 -->
        <section class="content-header">
            <h1>
                确诊病患管理 <small>新建病患</small>
            </h1>
            <ol class="breadcrumb">
                <li><a href="/indexpage"><i
                        class="fa fa-dashboard"></i> 首页</a></li>
                <li><a
                        href="/patient/list/">确诊病患管理</a></li>
                <li class="active">新建病患</li>
            </ol>
        </section>
        <!-- 内容头部 /-->

        <form action="/patient/addPatient" method="post">



            <!-- 正文区域 -->
            <section class="content"> <!--产品信息-->

                <div class="panel panel-default">
                    <div class="panel-heading">病患信息</div>
                    <div class="row data-type">

                        <input type="text" name="baseId"
                                    th:value="${baseId}" hidden="" >
                        <div class="col-md-2 title">感染源</div>

                        <div class="col-md-4 data">
                            <input type="text" class="form-control" name="infectionSource"
                                   placeholder="感染源" value="">
                        </div>

                        <div class="col-md-2 title">住院时间</div>
                        <div class="col-md-4 data">
                            <input type="date" class="form-control" name="onsetDate"
                                   placeholder="住院时间" value="">
                        </div>
                        <div class="col-md-2 title">症状</div>
                        <div class="col-md-4 data">
                            <input type="text" class="form-control" name="symptoms"
                                   placeholder="症状" value="">
                        </div>
                        <div class="col-md-2 title">诊治医院</div>
                        <div class="col-md-4 data">
                            <input type="text" class="form-control" name="hospital"
                                   placeholder="年龄" value="">
                        </div>
                        <div class="col-md-2 title">是否重症</div>
                        <div class="col-md-4 data">
                            <select class="form-control select2" style="width: 100%"
                                    name="critical">
                                <option value="是" selected="selected">是</option>
                                <option value="否">否</option>
                            </select>
                        </div>
                        <div class="col-md-2 title">备注</div>
                        <div class="col-md-4 data">
                            <input type="text" class="form-control" name="note"
                                   placeholder="备注" value="">
                        </div>
                    </div>
                </div>
                <!--订单信息/--> <!--工具栏-->
                <div class="box-tools text-center">
                    <button type="submit" class="btn bg-maroon">保存</button>
                </div>
                <!--工具栏/--> </section>
            <!-- 正文区域 /-->
        </form>
    </div>
    <!-- 内容区域 /-->

</div>


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